I am a prior authorization specialist getting doctors to comply with the documentation necessary to establish medical necessity for a service being requested is the most difficult part of my job. It seems that some doctors allow their ego as a medical provider to supersede doing what is necessary to get paid. It is excellent compliance in documentation that affords some doctors to be awarded the gold card. Oftentimes it's the lack of amendments to previous doctor's notes that describe the current changes or new occurrences that result in denials on the first submission. This can lead to peer-to-peer reviews with the Medical Director taking time away from patient care. I have the hardest time getting Nurses and Doctors to understand this.
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Thank you for this info 🙏🏼
I am a prior authorization specialist getting doctors to comply with the documentation necessary to establish medical necessity for a service being requested is the most difficult part of my job. It seems that some doctors allow their ego as a medical provider to supersede doing what is necessary to get paid. It is excellent compliance in documentation that affords some doctors to be awarded the gold card. Oftentimes it's the lack of amendments to previous doctor's notes that describe the current changes or new occurrences that result in denials on the first submission. This can lead to peer-to-peer reviews with the Medical Director taking time away from patient care. I have the hardest time getting Nurses and Doctors to understand this.